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For further information contact
Sports Medicine Australia
For a full list of references, contact Sports Medicine Australia.
Sports Medicine Australia wishes to thank the sports medicine
practitioners and SMA state branches who provided expert
feedback in the development of this fact sheet.
Images are courtesy of
The information in this resource is general in nature and is only intended
to provide a summary of the subject matter covered. It is not a substitute
for medical advice and you should always consult a trained professional
practising in the area of sports medicine in relation to any injury. You use or
rely on information in this resource at your own risk and no party involved in
the production of this resource accepts any responsibility for the information
contained within it or your use of that information.
© Papercut 719/2010
Soft tissue
A guide to prevention
and management
Soft tissue injuries are the most common injury in
sport. Soft tissue refers to tissues that connect, support,
or surround other structures and organs of the body.
A soft tissue injury generally involves one or more of
the following structures via sprain, strain or direct blows:
Muscle – muscles are made up of fibres that shorten
and lengthen to produce movement of a joint.
Muscles are attached to bone by tendons.
Tendon – tendons are tough bone of slightly elastic
connective tissue that connect muscle to bone.
Ligament – ligaments are strong bands of inelastic
connective tissue that connect bone to bone.
The biggest risk factor for soft tissue injury is a previous
injury. A player returning from injury or illness should
refrain from activity until declared fit to play by a sports
medicine professional.
Soft tissue includes muscles, tendons, ligaments,
fascia, nerves, fibrous tissues, fat, blood vessels,
and synovial membranes.
Warming up, stretching and cooling down.
Undertaking training prior to competition to ensure
readiness to play.
Including appropriate speed work in training programs so
muscles are capable of sustaining high acceleration forces.
Including appropriate stretching and strengthening
exercises in weekly training programs.
Gradually increasing the intensity and duration of training.
Maintaining high levels of cardiovascular fitness and
muscle endurance to prevent fatigue.
Allowing adequate recovery time between workouts
or training sessions.
Wearing appropriate footwear that is well fitted
and provides adequate support and traction for the
playing surface.
Wearing protective equipment, such as shin guards,
mouthguards and helmets.
Ensuring the playing surface and the sporting environment
is safe and clear of any potentially dangerous objects.
Drinking water before, during and after play.
Avoiding activities that cause pain.
Signs and symptoms
Types of soft tissue injuries include:
Acute injury
Injuries that occur from a known or sometimes unknown
incident. Signs and symptoms develop rapidly.
Bruise (contusion, cork)
Bruises are caused by a direct force applied to the body such
as being kicked or making contact with a player and result in
compression and bleeding into the soft tissue (hematoma).
Signs and symptoms: Swelling and/or discolouration.
Sprains are caused when the joint is forced beyond its normal
range of motion resulting in overstretching and tearing of the
ligament that supports the joint.
Signs and symptoms: Swelling, loss of power or ability to
bear weight, possible discolouration and bruising and/or
sudden onset of pain.
Strains are caused by muscles over-stretching or contracting
too quickly, resulting in a partial or complete tear of the
muscle and/or tendon fibres.
Signs and symptoms: Swelling, possible discolouration
and bruising and/or pain on movement.
Overuse Injury
Overuse injuries occur as a result of repetitive friction, pulling,
twisting, or compression that develops over time.
Signs and symptoms: Will develop slowly, inflammation, pain.
Rehabilitation and return to play
Immediate management
The immediate treatment of any soft tissue injury consists
of the RICER protocol – rest, ice, compression, elevation and
referral. RICE protocol should be followed for 48–72 hours.
The aim is to reduce the bleeding and damage within
the joint.
The No HARM protocol should also be applied – no heat,
no alcohol, no running or activity, and no massage. This will
ensure decreased bleeding and swelling in the injured area.
This regime should be used for all ligament sprains, muscle
sprains and muscle bruises. Referral for bumps and bruises
which occur in sport or physical activity, other than those
which are minor is recommended.
You can expect full recovery from most soft tissue injuries
in one to six weeks. The length of time depends on
your age, general health and the severity of the injury.
In significant injuries, a plaster cast or splint may be needed.
Sometimes surgery is the best option.